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LEAD SUBMISSION FORM
Carrier representatives, complete the following account information and use the submit button to send to the eShipping Exchange. For questions regarding the lead submission process, contact
[email protected]
.
EXCHANGE PARTNER INFORMATION
Exchange Carrier of Record
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Sales Rep Name
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Sales Rep Email Address
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Sales Rep Phone
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District Manager Name
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Territory Name
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District Manager Email Address
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ACCOUNT PROFILE
Account Name
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Carrier Customer Account Number
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Account DBA
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Parent Account
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Shipping Service
PARCEL
DIRECTSHIP
QUICKSHIP
INTERNATIONAL
TRUCKLOAD
TMS
Phone
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Website
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LOCATION
Street Address
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City
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State
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Zip Code
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Billing Address
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City
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State
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Zip Code
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ACCOUNT CONTACT
Name
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Title / Function
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Phone
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Email Address
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Select a choice
- Strength of Relationship
Poor
Weak
Fair
Strong
Strategic
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- Contact For Exchange Services -
Yes
No
GENERAL INFORMATION
Other Locations
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Annual Revenue
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Major Competitors
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Number of Employees
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Opportunity Detail
Anual Frieght Revenue
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% Currently Carrying
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Current Services Provided
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Reason For Opportunity
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Primary Objective for Engagement
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Select a choice
- Currently Using TMS?
Yes
No
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- Currently Using 3PL?
Yes
No
Select a choice
- Manual Freight Settlement -
Yes
No
Select a choice
- Bill Pay and Audit Outsourced -
Yes
No
TRANSPORTATION SUMMARY
LTL Annual Spend
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LTL Carriers Utilized
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LTL BOL # Per Month
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Select a choice
- Internal Fleet -
Yes
No
International Annual Spend
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Intermodal/Rail Annual Spend
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TL Annual Spend
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TL Carriers Utilized
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TL BOL # Per Month
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Parcel Annual Spend
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Parcel Carriers Utilized
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Air Freight Yearly Spend
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GENERAL NOTES OR COMMENTS
Untitled
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